Early onset anorexia nervosa: Multidisciplinary hospital intervention in a 1-year follow-up study.

Abstract

Early onset anorexia nervosa (EOAN) is a subclassification of AN, defined by an onset before 14 years, and characterized by specific demographic, neuropsychological, and clinical features. The present study aims to provide naturalistic data on a wide sample with EOAN, focusing on psychopathological and nutritional changes occurring in the context of a multidisciplinary hospital intervention, as well as the rate of rehospitalizations during a 1-year follow-up. Observational, naturalistic study adopting standardized criteria for EOAN (onset before 14 years). EOAN were compared to adolescent-onset AN (AOAN) patients (onset after 14 years) by demographic, clinical, psycho and treatment variables. Psychopathology was assessed at admission (T0) and discharge (T1) with self-administered psychiatric scales for children and adolescents (SAFA) subtests for Eating Disorders, Anxiety, Depression, Somatic symptoms, and Obsessions. Then, potential differences of T0-T1 changes in psychopathological and nutritional variables were assessed. Finally, rates of re-hospitalizations at 1-year post-discharge follow-up were assessed with Kaplan-Meier analyses. Two-hundred thirty-eight AN individuals (EOAN=85) were enrolled. When compared to AOAN, EOAN participants were more frequently males (X2=5.360, p= .021), more frequently received nasogastric-tube feeding (X2=10.313, p= .001), and risperidone (X2=19.463, p< .001), obtained a greater T0-T1 improvement in body-mass index percentage (F[1.229]=15.104, p< .001, η2=0.030), with higher 1-year freedom from re-hospitalization (hazard ratio, 0.47; Log-rank: X2=4.758, p= .029). In this study, describing the broadest EOAN sample available in literature so far, EOAN patients received specific interventions and obtained better outcomes at discharge and follow-up when compared to AOAN. Longitudinal, matched studies are required.